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Hysterectomy: What You Should Know


Has your healthcare provider recommended a hysterectomy? You’re not alone. According to the Office on Women’s Health, about 500,000 hysterectomies are performed each year in the U.S., making this procedure the second most common surgery among people with a female reproductive system. Read on to learn more about this surgery. We’ll cover the different types of hysterectomies, the common reasons why a hysterectomy is performed, questions to ask your doctor, and how to prepare.

What is a hysterectomy?

A hysterectomy is done to remove your uterus, also known as the womb. The uterus is a hollow organ of the female reproductive system. It looks like an upside-down pear, and it is where a baby grows if you’re pregnant. Depending on the reason for the hysterectomy, structures attached to your uterus – like your cervix, fallopian tubes, and ovaries – may be removed simultaneously. After a hysterectomy, you no longer have menstrual periods and can no longer get pregnant.

Types of hysterectomies

  • A partial hysterectomy – also called a supracervical hysterectomy – is when the upper part of the uterus is removed, but the cervix is left intact.
  • During a total hysterectomy, your uterus and cervix are removed.
  • If your uterus, cervix, and upper part of the vagina are removed, this is called a radical hysterectomy.

The type of hysterectomy you undergo depends on your condition and overall health. In some instances, a salpingo-oophorectomy – which involves the removal of your fallopian tubes and ovaries – may also be performed together with a hysterectomy.

Your surgeon may choose one of several ways (techniques) to perform your hysterectomy:

  • An abdominal hysterectomy or open hysterectomy: This is done through a large cut either up-down or side-to-side across your abdomen through which the uterus is removed. This type of surgery leaves a visible scar and requires a longer recovery time in the hospital.
  • A vaginal hysterectomy: This technique is minimally invasive because the uterus is removed through the vagina. Your surgeon goes through the vagina to make a cut around the cervix, then detaches and removes the uterus from there. A vaginal hysterectomy does not leave a visible scar and has shorter hospital stays, but it is not an option for everyone.
  • A laparoscopic hysterectomy: Through three or four tiny incisions in your belly, your surgeon uses a laparoscope – a thin tube with a camera attached– and other surgical tools to cut the uterus and remove it through your vagina. Nowadays, robotic technology is being added to this technique to allow for a better view during the surgery. This technique results in a few small scars and your recovery time with a laparoscopic hysterectomy or a robotic-assisted laparoscopic hysterectomy is much less.

Common reasons for a hysterectomy

You may need a hysterectomy if you have:

  • Uterine fibroids: A common condition where abnormal but benign (not cancer) growths develop in the uterus and cause symptoms like pelvic pain and bleeding between menstrual periods.
  • Cancer: A hysterectomy is a treatment option if you have cancer of the uterus (endometrial cancer), cervix, or ovary. You may also choose to have a hysterectomy if you have a genetic predisposition that puts you at risk of developing gynecologic cancer.
  • Severe vaginal bleeding: This can be caused by many conditions.
  • Uterine prolapse: A condition where – due to muscle weakness – the uterus falls into the vaginal canal, causing pressure and a bulge in the vagina.
  • Endometriosis: A common health problem that occurs when the tissue that lines inside the uterus starts growing outside of the uterus. Endometriosis can cause pain, bleeding between menstrual periods, and even the inability to have children.
  • Adenomyosis: An abnormality that causes the wall of the uterus to thicken, leading to heavy and painful menstrual periods.

Risks and side effects

Any surgery carries risks. The risks associated with a hysterectomy will depend on your health, any underlying condition, the type of hysterectomy, and the reason for the hysterectomy. Ask your surgeon about the risks based on your situation.

Common risks of a hysterectomy include:

  • Infection
  • Bleeding a lot during or after the surgery
  • Injury to nearby organs
  • Blood clots
  • Nerve and tissue damage
  • Problems from anesthesia
  • Problem having a bowel movement or urinating
  • Death

An abdominal hysterectomy may carry more risks than the other types; however, it’s important to be aware of the risks.

Some side effects you may notice after a hysterectomy are:

  • Menopausal symptoms (hot flashes, night sweats, vaginal dryness) if you had your ovaries removed
  • Loss of interest in sex
  • Grief or depression about the loss of fertility

After a hysterectomy, you may be at risk for long-term complications such as:

  • Loss of bladder control
  • Vaginal prolapse (the top of the vagina drops down into the vaginal canal)
  • Pain that doesn’t go away

Not all people are at the same risk of complications. Talk to your surgeon regarding the risks, side effects, and possible complications of a hysterectomy to help you decide the best option for you while receiving quality care.

Talking to your doctor

As you consider having a hysterectomy, here are 10 questions to ask your healthcare provider:

  1. Is there an alternative that may help with my condition?
  2. Will a hysterectomy cure my condition?
  3. What will happen if I don’t have a hysterectomy?
  4. What type of hysterectomy is recommended?
  5. Is egg preservation an option? (if you’re interested in having a child in the future)
  6. Will I require additional treatment after the surgery?
  7. What can I expect my scars to look like?
  8. How will a hysterectomy affect me physically and emotionally?
  9. What are the restrictions while I recover from the surgery?
  10. How long will it take to recover?

How to prepare for your hysterectomy

Having a hysterectomy is a big decision. Once you have the answers to the questions above, here are ways you can prepare to make the process a bit easier:

  • Talk to your partner. A hysterectomy may have physical and emotional effects on you and your partner if you have one. Your sexual life may also be affected. Discuss these anticipations with your partner and how you will cope. Talk to your doctor about them as well.
  • Stop smoking. If you’re a smoker, your doctor will talk to you about stopping or cutting down on smoking. In addition to the other benefits of not smoking – like reducing your risk of cancer – this step is essential to help with healing and recovery.
  • Plan ahead and enlist the help of others. Recovery from a hysterectomy takes time, and you will need support. You will also have certain restrictions for several weeks. Make arrangements to have someone help you during the recovery.
  • Follow the pre-surgery instructions. Your doctor will provide instructions about eating, drinking, and bowel preparation before your surgery. Make sure you understand and follow them to help you have a successful procedure.

Conclusion

A hysterectomy is a major surgery that may be done to give you relief from symptoms and to remove a tumor. It’s important to ensure you understand the risks and complications of a hysterectomy. Discuss other treatment options with your doctor to ensure you are fully informed to make the best decision. Preparing for your hysterectomy will help make the recovery easier. Don’t forget to talk to your partner and family about your decision to have a hysterectomy so they can support you during your recovery.

Key takeaways

For certain medical conditions, a hysterectomy – removal of the uterus – may become necessary.

There are different types of hysterectomies – some involve the removal of the uterus alone while others involve removal of the uterus and additional structures – and your surgeon may perform the surgery using various techniques.

If you’re facing a hysterectomy, talk to your healthcare provider about alternatives if appropriate for your condition, as well as risks, side effects, and possible long-term complications.

Prepare for your hysterectomy, think about your day-to-day activities, and let others help you during the recovery.

Resources:

American Cancer Society. How Surgery Can Affect the Sex Life of Females with Cancer.

American College of Obstetricians and Gynecologists. Hysterectomy.

Medline. Hysterectomy.

Office on Women’s Health. Hysterectomy.

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